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General NPI Number Information
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NPI Number | 1750573200
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO Y BACTERIOLOGICO GLADYAN INC.
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | CALLE CATALINA MORALES NO 5 SUITE #2
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City | YABUCOA
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State | PR
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Zip | 00767
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Country | US
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Telephone | 787-266-3300
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Fax | 787-266-3500
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Provider Business Mailing Address
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Address Line | CALLE CATALINA MORALES NO 5 SUITE #2
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City | YABUCOA
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State | PR
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Zip | 00767
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Country | US
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Telephone | 787-266-3300
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Fax | 787-266-3500
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | JOSE A TORRES-AZIZE
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Credential |
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Telephone | 787-266-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1132
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License Number State | PR
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